Copy Of 5th Yr Exam

FACUILTY OF MEDICINE PEDIATRIC DEPARTMENT

5TH YEAR FINAL PEDIATRIC EXAMINATION Thursday,23,11,2007

Time allowed 3 hours

I-Essay 1

.Discuss diagnosis of Hemophilus influenza b Infections

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. Discuss differential diagnosis of Neonatal Central Cyanosis

3

.Discuss management of an Acute Lymphoblastic Leukemia

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.Discuss prevention of Persistent Diarrhea

I- 4 II- 10

This exam includes Essay Questions marks 100 Problems Solving marks 40 III- 20 MCQs marks 20

Exam Oral Clinical Clinical

Students All 1-95 end of list-96

Date 28/10/2007 29/10/2007 30/10/2007

Thurday,25/10/2007 Revision on Diagnostic Tools at 09 o’clock

In Pediatric Department Outpatient Clinic

II-Problem Solving 1

A B 2

A B 3

A B 4 A B 5

A B

A male patient aged 15 years with a recent history of intestinal schistosomiasis. He was presented with hepatomegaly. Serum aspartate aminotransferase was 500 U/L. Doppler study revealed .that pressure in portal venous system was 10 mmHg -----------------------------------------------------------------------------.Mention the definitive diagnosis of active intestinal schistosomiasis ?What is the complication that should be considered in this child A 5-year-old boy is presenting with eye opening in response to speech, inappropriate words in response to verbal stimuli and .decorticates posture in response to pain --------------------------------------------------------------------?What is Glasgow Coma Score of this boy .Mention 4 drugs that their overdoses may lead to coma A 3-year-old boy is brought to the office with arthritis after a minor trauma. There was a past history of excessive bleeding after .circumcision. His uncle had the same presentation --------------------------------------------------------------------------?What is the most accepted diagnosis Mention 2 laboratory investigations for prenatal diagnosis of this .presentation A 3 –day-male newborn infant presents with jaundice and a large .cranial swelling localized to cranial bone ----------------------------------------------------------------------------?What the most accepted diagnosis .Mention CNS complication that may occur in this disease A mal-nuritioned infant presenting with fever, vomiting, diarrhea and shock. His weight was 70% of normal .There was a lower limb .edema -----------------------------------------------------------------------------.Mention the most accepted diagnosis of this presentation .Mention the type and dose of ideal IV fluid therapy for this infant

6

A male child 7 years old was presented with generalized edema. He was attended to ICU with sudden onset of .fever, severe abdominal pain, and vomiting Examination revealed abdominal tenderness and positive .shifting dullness. Urine analysis revealed heavy proteinuria ---------------------------------------------------------------------------A ?What is the accepted diagnosis B .?What is the complication that should be considered

7

A B 8

A B 9

A B 10

A B

A 3 years old boy has a history of ingestion of large amount tonic preparation. He presenting with severe vomiting and :diarrhea. Investigation reveals RBCs=5.0million/cmm; WBCs=10,000/cmm; and Serum .%iron=350 ug ----------------------------------------------------------------------?What is the most likely diagnosis ?What is the type and dose of chelating agent that may be used A child 3 years old was presented with generalized edema; severe hypertension, gross hematuria, mild proteinuria and .oliguria . Mitral Doppler flow revealed E/A=0.8 ------------------------------------------------------------------?What is the most accepted diagnosis of this presentation ?What is the complication that should be considered During routine neonatal screening, a drop of blood obtained by heel prick at 7th day of life. A serum T4 was 10 microgram ./ml -------------------------------------------------------------------?What is the normal serum T4 .Mention the dose of Sodium L-thyroxin in neonatal period A 5 months-old-girl with delayed all mile stones is presenting with recurrent attacks of flexor spasms in form of sudden drop .of the head and flexion of arms & legs ---------------------------------------------------------------------?What is the most accepted diagnosis of this presentation ?What is the characteristic EEG pattern of this disease

III-MCQ 1

A 6 month old infant can do the following except

2

:The average weight at 10 years is

3

At one year age, chest circumference measuring

4

:The average age of closure of AF is

5

The period of early childhood is :characterized by the following except

6

The most common cause of convulsion in infant aged 11 months is

7

Recurrence risk of Down syndrome with :t(21q 21q) and carrier mother is+,46

8

In the dried skimmed milks the fat :content is

9

:The vitamin E deficiency produce

10

The laboratory test which should demonstrated in all patients with active :systemic lupus erythematosus is

A-Sit alone .B-Transfer rattles from hand to hand .C-Recognize his mother .D-Chew food A-30 kg B-32.5kg C- 35kg D-40kg A-30 cm B-35 cm C-40 cm D-45 cm A-4 -24 months B-8 -15 months C-6 -18 months D-10-20 months A-Weaning B-Accident C-Nutritional disorders D-Emotional problems A-Febrile convulsion B-Meningitis C-Tetanus D-Brain tumor A-5% B-15% C-25% D-100% A-0.25% B-0.5% C-1.0% D-Non of above A-Skin lesion B-Angular stomatitis C-Hemolysis in prematures D-Bleeding gums (A-ANA(Antinuclear Antibody (B-C3(Complement C3 C-Double-stranded DNA antibody D-Anticardiolipin

11 The modified Measles is characterized :by

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13

14

15

.A-Occurring in partially immune infant .B-A generally mild course C-Following the regular sequence of events in .measles .D-All of the above Infection with Gardia is characterized by A-It affects mainly children with malnutrition :the following except B-Symptoms develop 3-5 days after exposure .to parasite C-Ingestion of 10 cysts are sufficient to produce infection D-The most common presentation is diarrhea The ideal dose of IV atropine in A-0.05 mg/kg :treatment of bradycardia is B-1.0 mg/kg C-2.0 mg/kg D-0.02 mg/kg A purulent pleural effusion is A-Glucose 50-100mg/dl :characterized by the following except B-Polymorph Nuclear Cells > 5000/cmm C-Cloudy .D-May follow lung abscess A child with bronchial asthma and had 4 A-Intermittent asthma attacks a week .He is free between attacks B-Mild persistent asthma with slight decrease pulmonary function C-Moderate persistent asthma :tests. This child is classified as .D-Severe persistent asthma

16 The following data are signs of rheumatic Carditis except 17 A child aged 10 years suffering from rheumatic arthritis. There is no cardiac affection. Duration of Benzathine : Penicillin G will be 18 The normal urine volume

19 :Kausmaul sign means

20 The most common cause of secondary :hypertension is

A-Musical sound B-New murmur C-Frictionl rub D-Muffled S1 .A-For Life B-Till 25 years of age C-For 5 years D-Non of above A-less than 400cc/day B-1.5-3.5cc/kg/day C-1cc/kg/day D-non of above A-Congested neck veins B-Markedly congested neck veins with inspiratory filling C-Congested pulsating neck veins .D-Non of above A - Renal B- Cardiac C- Endocrinal D- CNS

23/10/2007 .(Model Answer of MCQ (ONE Mark for each Question 1 A 2 B 3 D 4 C 5 D 6 A 7 D 8 B 9 C 10 A 11 D 12 B 13 D 14 A 15 B 16 D 17 B 18 D 19 20

B A

Problem Solving (2 marks for each question ) Total 40 marks 1 2

3 4 5

A B A B

.Findings of viable shistosomiasis eggs in stool Hepatitis 9 Atropine-Barbiturates-Salycilate-morphia

A B A B A B

Hemophilia A Chorionic villus sampling-Aminocentesis-Fetal blood Sampling Cephalhematoma Kericterus KWO complicated with gastroenteritis Ringer’s Lactate; 20cc/kg

6

A NS B Peritonitis

7

A B A B A B A B

8 9 10

Acute iron intoxication Desferoxamine;12-15 mg/kg/hr AGN Diastolic HF ug/dl 5-15 mg/kg 10-15 Infantile Spasm Hypsarrythmia 23/10/2007

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